B Lehner1, M Jung, F von Stillfried. 1. Sektion Orthopädische Onkologie und Septische Orthopädische Chirurgie, Abteilung für Orthopädie und Unfallchirurgie, Universitätsklinik Heidelberg, Schlierbacher Landstr. 200a, 69118, Heidelberg, Deutschland. burkhard.lehner@med.uni-heidelberg.de
Abstract
OBJECTIVE: Total tumor resection and defect resconstruction by vascularized fibula graft and total wrist fusion. INDICATIONS: Primary extended bone tumors of the distal radius. CONTRAINDICATIONS: Tumor infiltration of the whole carpus or of the neurovascular structures. SURGICAL TECHNIQUE: En bloc resection of the tumor including the biopsy scar. Raising of a microvascular fibula graft including the peroneal vessels. Defect reconstruction using the fibula and stabilization of the total wrist fusion with a locking compression plate (LCP). POSTOPERATIVE MANAGEMENT: Functional therapy of the fingers is possible, below elbow cast for 6 weeks. Weight bearing after 12 weeks according to bone healing. RESULTS: The operation technique described for preservation of the extremity in primary extended bone tumors of the distal radius was performed in our clinic in 2 patients since 2009. Tumor-free and pain-free hand function was found at the 2.5-year follow-up examinations. The patients had free range of motion of the fingers and preserved sensorimotor function. The MSTS (Musculoskeletal Tumour Society) scores by Enneking were 80% and 70%.
OBJECTIVE: Total tumor resection and defect resconstruction by vascularized fibula graft and total wrist fusion. INDICATIONS: Primary extended bone tumors of the distal radius. CONTRAINDICATIONS: Tumor infiltration of the whole carpus or of the neurovascular structures. SURGICAL TECHNIQUE: En bloc resection of the tumor including the biopsy scar. Raising of a microvascular fibula graft including the peroneal vessels. Defect reconstruction using the fibula and stabilization of the total wrist fusion with a locking compression plate (LCP). POSTOPERATIVE MANAGEMENT: Functional therapy of the fingers is possible, below elbow cast for 6 weeks. Weight bearing after 12 weeks according to bone healing. RESULTS: The operation technique described for preservation of the extremity in primary extended bone tumors of the distal radius was performed in our clinic in 2 patients since 2009. Tumor-free and pain-free hand function was found at the 2.5-year follow-up examinations. The patients had free range of motion of the fingers and preserved sensorimotor function. The MSTS (Musculoskeletal Tumour Society) scores by Enneking were 80% and 70%.